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Cervical Cancer Screening

January 27, 2016 Healthcare News

What is cervical cancer?

Cervical cancer develops when cells in the cervix begin to grow out of control and can then invade nearby tissues or spread throughout the body. Cervical cancer usually develops very slowly. It starts as a precancerous condition called dysplasia. This precancerous condition is 100% treatable.

Figures

Worldwide, cervical cancer is the second most common cancer in women and the third leading cause of deaths. Cervical cancer is the 2nd leading cancer and 7th cause of deaths for females in UAE. Most of the cases of cervical cancer in UAE are not detected until they are in the late stages, when it is difficult to treat.

What Are the Symptoms of cervical cancer?

Early on, cervical cancer may not cause signs and symptoms. Advanced cervical cancer may cause bleeding or discharge from the vagina that is not normal for you, such as bleeding after sex.

Can cervical cancer be prevented?

The most common form of cervical cancer starts with pre-cancerous changes and there are ways to stop this disease from developing. The first way is to find and treat pre-cancers before they become true cancers, and the second is to prevent the pre-cancers.

If a pre-cancer is found it can be treated, stopping cervical cancer before it really starts. Most invasive cervical cancers are found in women who have not had regular Pap tests.

Finding cervical pre-cancers

A well-proven way to prevent cervical cancer is to have screening to find pre-cancers before they can turn into invasive cancer. The Pap test (or Pap smear) and the human papilloma virus (HPV) test are used for this.

What is cervical cancer screening?

Cervical screening is a way of preventing cancer by finding and treating early changes in the neck of the womb (cervix). These changes could lead to cancer if left untreated.

What is the smear (cervical cancer screening) test?

A doctor takes a sample of cells from the cervix with a small brush. She sends the sample to a laboratory to be checked for abnormalities. In some cases, samples are also tested for a virus called human papilloma virus (HPV) that increases the risk of cervical cancer.

Cervical Screening Program

Health Authority of Abu Dhabi screening program invites all sexually active women from ages 25 to 64 for cervical screening. Women aged 25 to 49 are invited every 3 years. After that, women are invited every 5 years until the age of 64.

What is the role of human papillomavirus (HPV)?

HPV infection with High Risk types can cause cells in the cervix to change gradually over time. This may lead to pre-cancerous cells forming. These changes can develop into cancer over time if not treated.

The pre-cancerous change in the cells is known as cervical intraepithelial neoplasia (CIN). Having these types of HPV infection does not mean that you will definitely go on to develop cancer of the cervix. However, your risk of developing cancer of the cervix is much increased with these infections.

This is why checking for HPV has recently become part of some smear tests. If you have HPV found in your smear sample, doctors will test you more regularly, and you are more likely to need treatment for minor changes. HPV infection is passed to other people by sexual contact, usually through having sex. It is more common, therefore, in those people who have had several different sexual partners. Unfortunately, the use of condoms does not seem to protect very well against HPV transmission. Condoms prevent some cases, but not all. Safe sex with a condom is still advised, as condoms prevent against many other sexually transmitted infections.

Can HPV infection be prevented?

Two HPV vaccines are available in the UAE: Cervarix® and Gardasil®. Cervarix known as a bivalent vaccine, meaning it protects against two strains of HPV. Cervarix® protects against HPV16 and HPV18 and so is aimed to reduce the number of cases of cervical cancer.

Gardasil is a quadrivalent vaccine, meaning it protects against four strains of HPV. Gardasil® protects against HPV16, HPV18 and HPV6 and HPV11 which leads to protection against genital warts as well as cervical cancer.

Human Papillomavirus (HPV) vaccination program

The Health Authority Abu Dhabi has approved the HPV vaccine for girls and young women, 15 to 26 years of age, for the prevention of cervical cancer and its precursors. Studies have shown that immunogenicity of the vaccines is higher when administered at a younger age therefore each girl is encouraged to take the vaccine as early as possible during the adolescence age and some years before marriage.

Is the human papillomavirus (HPV) vaccine effective?

Studies have shown that the HPV vaccines are very effective at stopping cancer of the neck of the womb (cervix) developing. In clinical trials, the vaccine was over 99% effective at preventing pre-cancer or cancer of the cervix associated with HPV types 16 or 18 in young women. Gardasil® is also 99% effective at preventing HPV6- and HPV11-associated genital warts. The HPV vaccines do not prevent all cases of cervical cancer (as not all cervical cancers are caused by HPV16 and HPV18). So, it is still important that women attend for their cervical screening tests when invited.

This article is contribute by:

Dr. Marjan Mazhari – Consultant Obstetrics and Gynaecology, NMC Hospital, DIP, Dubai

Dr. Marjan is qualified Gynaecologic Oncologist and has obtained Fellowship in Gynaecologic Oncology. She has more than 18 years of experience in Obstetrics and Gynaecology.

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